SUMMARY OF PRODUCT CHARACTERISTICS

1 NAME OF THE MEDICINAL PRODUCT

Allerief 2mg/5ml Oral Solution

Chlorphenamine Maleate 2mg/5ml Oral Solution

2 QUALITATIVE AND QUANTITATIVE COMPOSITION

Each 5ml contains 2mg of Chlorphenamine Maleate. Excipients with known effect:

Sodium methyl parahydroxybenzoate (E219) 9mg/5ml Sodium propyl parahydroxybenzoate (E217) 1mg/5ml Maltitol Liquid (E965) 1.0ml/5ml

For the full list of excipients, see section 6.1.

3    PHARMACEUTICAL FORM

Oral Solution

Clear, colourless solution.

4    CLINICAL PARTICULARS

4.1    Therapeutic indications

Allerief is indicated for the symptomatic control of all allergic conditions responsive to antihistamines including hay fever, allergic rhinitis, vasomotor rhinitis, urticaria, angioneurotic oedema, food allergy, drug and serum reactions, insect bites. It is also indicated for the symptomatic relief of itch associated with chickenpox.

4.2    Posology and method of administration

For oral administration.

Do not exceed the stated dose or frequency of dosing.

Age	Dose
Children below 1 year:	Not recommended.
Children aged 1 - 2 years:	2.5ml (1mg) twice daily. The minimum interval between the doses should be 4

	hours. Maximum daily dose: 5ml (2mg) in any 24 hours.
Children aged 2 - 6 years:	2.5 ml (1mg) every 4 to 6 hours. Maximum daily dose: 15ml (6mg) in any 24 hours.
Children aged 6 - 12 years:	5ml (2mg) every 4 to 6 hours. Maximum daily dose: 30ml (12mg) in any 24 hours.
Adults and children 12 years and over:	10ml (4mg) every 4 to 6 hours. Maximum daily dose: 60ml (24mg) in any 24 hours.

Not recommended for children below 1 year

Special _ populations Elderly

The elderly are more likely to experience neurological anticholinergic effects. Consideration should be given to using a lower daily dose (e.g. a maximum of 12 mg in any 24 hours).

4.3    Contraindications

Allerief is contra-indicated in patients who are hypersensitive to antihistamines or to any of the excipients listed in section 6.1.

The anticholinergic properties of chlorphenamine are intensified by monoamine oxidase inhibitors (MAOIs). Allerief is therefore contra-indicated in patients who have been treated with MAOIs within the last fourteen days (see section 4.5).

4.4    Special warnings and precautions for use

Chlorphenamine in common with other drugs having anticholinergic effects, should be used with caution in epilepsy, raised intra-ocular pressure including glaucoma, prostatic hypertrophy; severe hypertension or cardiovascular disease; bronchitis, bronchiectasis or asthma; hepatic impairment, renal impairment, pyloroduodenal obstruction and thyrotoxicosis.

Children and the elderly are more likely to experience the neurological anticholinergic effects and paradoxical excitation (e.g. increased energy, restlessness, nervousness).

The anticholinergic properties of chlorphenamine may cause drowsiness, dizziness, blurred vision and psychomotor impairment in some patients which may seriously affect ability to drive and use machinery.

The effects of alcohol may be increased and therefore concurrent use should be avoided.

Chlorphenamine should not be used with other antihistamine containing products, including antihistamine containing cough and cold medicines.

Chlorphenamine Oral Solution contains sodium methyl parahydroxybenzoate (E219) and sodium propyl parahydroxybenzoate (E217). These may cause allergic reactions (possibly delayed).

It also contains Maltitol Liquid (E965). Patients with rare hereditary problems of fructose intolerance should not take this medicine.

Keep out of the sight and reach of children.

4.5    Interaction with other medicinal products and other forms of interaction

This medicine may enhance the sedative effects of alcohol, hypnotics, anxiolytics, sedatives, opioid analgesics and neuroleptics, therefore medical advice should be sought before taking chlorphenamine concurrently with these medicines.

The antimuscarinic effects of Chlorphenamine are enhanced by other antimuscarinic drugs and both anticholinergic and sedative effects are enhanced by monoamine oxidase inhibitors (MAOIs) (concurrent therapy with which is contraindicated, see 4.3 above) and tricyclic antidepressants.

Metabolism of phenytoin may be inhibited by Chlorphenamine with the possible development of phenytoin toxicity.

4.6    Fertility, pregnancy and lactation

Pregnancy

There are no adequate data from the use of Chlorphenamine in pregnant women. The potential risk for humans is unknown; Use during the third trimester may result in reactions in the new born or premature neonates. Not to be used during pregnancy unless considered essential by a physician.

Breast-feeding

Chlorphenamine maleate and other antihistamines may inhibit lactation and may be secreted in breast milk and its use is not recommended in nursing mothers because of the risk of adverse events such as unusual excitement or irritability in infants. Not to be used during lactation unless considered essential by a physician.

4.7    Effects on ability to drive and use machines

The anticholinergic properties of chlorphenamine may cause drowsiness; dizziness, blurred vision and psychomotor impairment which can seriously hamper patient’s ability to drive and use machinery.

Undesirable effects

Specific estimation of the frequency of adverse events for OTC products is inherently difficult (particularly numerator data). Adverse reactions which have been observed in clinical trials and which are considered to be common (>1/100 to <1/10) or very common (>1/10) are listed below by MedDRA System Organ Class. The frequency of other adverse events identified during post-marketing use is unknown.

System Organ Class	Frequency of occurrence
	Very common	Common	Not known
Blood and lymphatic system disorders			haemolytic anaemia, blood dyscrasias
Immune system disorders			allergic reaction, angioedema, anaphylactic reactions
Metabolism and nutritional disorders			anorexia
Psychiatric disorders			confusion*, excitation*, irritability*, nightmares*, depression
Nervous system disorders*	sedation, somnolence	disturbance in attention, abnormal coordination, dizziness, headache
Eye disorders		blurred vision
Ear and labyrinth disorders			tinnitus
Cardiac disorders			palpitations, tachycardia, arrhythmias
Vascular disorders			Hypotension
Respiratory, thoracic and Mediastinal disorders			thickening of bronchial secretions
Gastrointestinal disorders		nausea, dry mouth	vomiting, abdominal pain, diarrhoea, dyspepsia
Hepatobiliary disorders			hepatitis including jaundice
Skin and subcutaneous disorders			exfoliative dermatitis, rash, urticaria, photosensitivity
Musculoskeletal and connective tissue disorders			muscular twitching, muscle weakness
Renal and Urinary disorders			Urinary retention
General disorders		fatigue	chest tightness

and paradoxical excitation (e.g. increased energy, restlessness, nervousness). Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard.

4.9 Overdose

Symptoms and signs

The estimated lethal dose of chlorphenamine is 25 to 50mg/kg body weight. Symptoms and signs include sedation, paradoxical excitation of the CNS, toxic psychosis, convulsions, apnoea, anticholinergic effects, dystonic reactions and cardiovascular collapse including arrhythmias.

Treatment

Symptomatic and supportive measures should be provided with special attention to cardiac, respiratory, renal and hepatic functions and fluid and electrolyte balance. If overdosage is by the oral route, treatment with activated charcoal should be considered provided there are no contraindications for use and the overdose has been taken recently (treatment is most effective if given within an hour of ingestion.) Treat hypotension and arrhythmias vigorously. CNS convulsions may be treated with i.v. diazepam. Haemoperfusion may be used in severe cases.

5    PHARMACOLOGICAL PROPERTIES

5.1    Pharmacodynamic properties

Pharmacotherapeutic group: Antihistamines for systemic use, substituted alkylamines, ATC code: R06AB04

Chlorphenamine is a potent antihistamine (H1-antagonist).

Antihistamines diminish or abolish the actions of histamine in the body by competitive reversible blockade of histamine H1-receptor sites on tissues. Chlorphenamine also has anticholinergic activity.

Antihistamines act to prevent the release of histamine, prostaglandins and leukotrienes and have been shown to prevent the migration of inflammatory mediators. The actions of Chlorphenamine include inhibition of histamine on smooth muscle, capillary permeability and hence reduction of oedema and wheal in hypersensitivity reactions such as allergy and anaphylaxis.

5.2 Pharmacokinetic properties

Chlorphenamine is well absorbed from the gastro-intestinal tract, following oral administration. The effects develop within 30 minutes, are maximal within 1 to 2 hours and last 4 to 6 hours. The plasma half-life has been estimated to be 12 to 15 hours.

Chlorphenamine is metabolised to the monodesmethyl and didesmethyl derivatives. About 22% of an oral dose is excreted unchanged in the urine.

5.3 Preclinical safety data

No additional data of relevance.

6    PHARMACEUTICAL PARTICULARS

6.1    List of excipients

Glycerol

Maltitol Liquid (E965)

Citric Acid Monohydrate

Sodium Methyl parahydroxybenzoate (E219)

Sodium Propyl parahydroxybenzoate (E217)

Strawberry Flavour (contains Propylene Glycol)

Saccharin Sodium

Purified Water

6.2    Incompatibilities

Not applicable.

6.3    Shelf-Life

24 months.

6.4 Special precautions for storage

Do not store above 25°C. Store in the original container.

6.5    Nature and contents of container

Amber Type III glass bottle.

Child resistant, tamper-evident polypropylene cap.

2.5    / 5ml-measuring spoon is supplied Pack sizes: 100ml and 150ml bottle.

6.6    Special precautions for disposal

No special requirements.

7    MARKETING AUTHORISATION HOLDER

Orbis Consumer Products Limited

Cunard Road

Park Royal

London

NW10 6PN

8. MARKETING AUTHORISATION NUMBER

PL 17862/0002

9    DATE OF FIRST AUTHORISATION/RENEWAL OF THE

AUTHORISATION

16/12/2008

10 DATE OF REVISION OF THE TEXT

10/11/2015